The use of an automatic stapling device for laparoscopic appendectomy.

Laparoscopic appendectomy, for years performed only occasionally, is becoming more common with the increasing interest by both general surgeons and gynecologists in "minimally invasive surgery." A recently available automatic laparoscopic stapling system (the MULTI-FIRE ENDO GIA 30) claims to make laparoscopic appendectomy technically easier to perform. The technique of laparoscopic appendectomy using this automatic stapling device was evaluated in ten patients and compared with our previous laparoscopic techniques. The MULTI-FIRE ENDO GIA passes through a 12-mm trocar and allows placement of two triple-staggered lines of titanium staples with a simultaneous cut. Using this technique, operating time for laparoscopic appendectomy was reduced from an average of 30 to a minimum of 5 minutes. With this technique, no appendiceal contents leaked intraperitoneally. The larger trocar allowed easier removal of the separated appendix with minimal dissection of the mesoappendix. Indications for appendectomy included endometriosis of the appendix (three), fixation to the right tube or ovary (three), early acute appendicitis (two), and elective removal (two). There were no immediate or late complications. Our preliminary experience with the MULTI-FIRE ENDO GIA 30 stapler suggests that it is a safe, easy, and rapid method of removing the appendix laparoscopically.